HRD-93-11: Published: Nov 4, 1992. Publicly Released: Nov 4, 1992.

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Pursuant to a legislative requirement, GAO reviewed the National Marrow Donor Program (NMDP), focusing on: (1) the recruitment of volunteer marrow donors; (2) why potential donors were only partially typed for compatibility; (3) the outcomes and costs of patients' searches for donors; (4) the incorporation of changes in bone marrow research and clinical practices into the program; and (5) the role of federal funding. GAO also provided information on the American Bone Marrow Donor Registry.

GAO found that: (1) from December 1989 to April 1992, registered donors increased from 72,900 to 560,871; (2) minority donors more than doubled to 14.2 percent, but their proportions remained considerably less than in the general population; (3) community drives recruited more than 50 percent of the new donors, and also raised funds for typing that were matched by the program; (4) because of test costs and the commonality of certain antigen combinations among nonminorities, new donors were only partially typed, but this caused delays in finding donors for patients with rarer combinations; (5) with increased federal funding, NMDP began to type fully donors with rarer antigen combinations, and to store blood of other new donors for full typing if they became potential donors for a patient; (6) although transplants increased, most search requests between September 1, 1987, and July 18, 1991, did not result in a transplant, and almost one third were cancelled; (7) the median charge for a search that resulted in a transplant was $20,000; (8) for the first 6 months of 1991, private insurers paid for 50 percent of searches, while hospitals, charitable funds and state government funds paid for 20 percent, Medicaid and Medicare paid for 15 percent, uninsured patients paid for 10 percent, and 5 percent were unreimbursed; (9) NMDP approved researchers' access to its database, member organizations, and donors, when the research supported its research priorities and had potential benefits for the program; and (10) NMDP is participating in bone marrow research and is beginning to incorporate preliminary research findings into its program.